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Guowei Zhang
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P1.04 - Immuno-oncology (ID 164)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.04-68 - Liver Metastases Predicts Poorer Prognosis in Advanced NSCLC Patients Who Receiving Nivolumab Monotherapy (ID 232)
09:45 - 18:00 | Presenting Author(s): Guowei Zhang
- Abstract
Background
Nivolumab is a fully human IgG4 monoclonal antibody targeting the programmed death-1 (PD-1). It's a standard second-line treatment for advanced NSCLC. Liver metastases(LM) is one of the worst prognostic NSCLC metastatic sites, but the attention to LM is far lower than brain metastases and bone metastases.
Method
Patients with stage IIIB-IV NSCLC treated with second-line or later nivolumab monotherapy were retrospectively collected from January 2016 to July 2018. The patients were divided into two cohorts based on the presence or absence of LM at the time of first dose. Study endpoints included OS and PFS.
Result
65 patients were included, including 10 patients with and 55 patients without LM. Baseline characteristics of the two cohorts were comparable, as shown in the below table.
The median OS of the patients with and without LM was 7.5 and 20.7 months, respectively（HR =4.81；95%CI, 1.28-18.00；p=0.020）. Their median PFS was 1.9 and 5.6 months, respectively（HR =4.47；95%CI, 1.61-12.35；p=0.004). COX multivariate regression analysis suggested LM was an independent prognostic factor. Kaplan-Meier curves of OS and PFS were shown in the below figure.
Conclusion
The outcome of advanced NSCLC patients with LM treated with Nivolumab monotherapy is relatively poor compared with those without LM.
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P2.14 - Targeted Therapy (ID 183)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.14-45 - EML4-ALK Fusion Subtype Is Associated with Therapeutic Efficacy in Advanced Non-Small Cell Lung Cancer (Now Available) (ID 2134)
10:15 - 18:15 | Author(s): Guowei Zhang
- Abstract
Background
The aim of this study was to investigate the molecular characteristics of each subtype of the EML4-ALK fusion gene and to evaluate the efficacy of first-line crizotinib or pemetrexed in combination with platinum in the treatment of patients with advanced NSL4-ALK fusion subtypes of advanced NSCLC.
Method
From August 2015 to September 2018, the clinicopathological data of patients who received driver genes detection for lung cancer in the Affiliated Cancer Hospital of Zhengzhou University were collected,NGS was used for gene detection.The EML4-ALK fusion gene was divided into E13: A20 subtype (variant 1, V1), E20: A20 subtype (variant 2, V2), E6: A20 subtype (variant 3, V3) and Other subtypes (V4) 4 groups. The primary study endpoint was progression-free survival.
Result
A total of 122 patients with ALK fusion gene-positive NSCLC were screened. Of the 122 patients, 41 (33.6%) had V1 variants, 14 (11.5%) had V2 variants, 35 (28.7%) had V3 variants, and 32 (26.2%) had other variants. There was no correlation between EML4-ALK gene mutation subtypes and distant metastasis (x2=0.570, P=0.903), brain metastasis (x2=4.447, P=0.217) and bone metastasis (x2=1.547, P=0.672). The median was 13.3 months (95% CI: 9.45-17.10) and 6.83 months (95% CI: 5.30-8.36),respectively, in patients receiving first line Crizotinib and chemotherapy, with statistically significant differences (P =0.001). In the first-line application of crizotinib, the ORR of V1, V2, V3 and V4 variants were 55.56% (10/18), 62.50% (5/8), 44.44% (4/9) and 43.75%, respectively. (7/16), median PFS were 11.96 months, 15.08 months, 12.88 months, and 7.62 months, respectively. There was no significant difference. The ORR of V1, V2, V3 and V4 variants in first-line patients treated with pemetrexe-platinum regimen was 41.18%(7/17), 37.50% (3/8), 36.36%(4/11)and 41.18% (7/17), respectively. The median PFS were 9.13 months, 3.22 months, 7.52 months, and 7.85 months, respectively. There was no statistically significant difference in PFS between V1: V3, V2: V3, and V1: V4. However, the PFS differences in the V1:V2 group (V1:V2=9.13 months: 3.22 months, P=0.007) and the V2:V4 group (V2:V4=3.22 months: 7.85 months, P=0.015) .
Conclusion
Among all ALK fusion subtypes, E13:A20 subtype (V1 variants) is the most common. Smoking history was a factor affecting crizotinib PFS.Compared with chemotherapy, patients with E20:A20 subtype (V2 variant) showed significant benefit with crizotinib.The median PFS of the pemetrexed combined with platinum regimen was lower than that of the E13:A20 subtype.
